Implementing a Lean Management System in Primary Care

Hung, Dorothy; Martinez, Meghan; Yakir, Maayan; Gray, Caroline

doi:10.1097/qmh.0000000000000062

Cited by 38 publications

(12 citation statements)

References 23 publications

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“…One of the personal barriers for implementing lean management addressed in the studies was the resistance against the change which in studying other department often had been addressed [64-67]. Since the implementation of lean management is an invisible change, the staff resistance is apparently inevitable.…”

Section: Discussionmentioning

confidence: 99%

Features and Results of Conducted Studies Using a Lean Management Approach in Emergency Department in Hospital: A Systematic Review

Isfahani

Tourani

Seyedin

2019

BEAT

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Objective:To perform a systematic review of the properties and results of the studies that their approaches are lean management in emergency departments and the factors which influence on their performance. Method:The necessary information in the first stage was collected by searching these keywords: "Lean principles" “Lean Six Sigma", "Lean Process", “Lean thinking”, “Lean Methodology”, “Toyota Production System lean processing”, "lean techniques", "emergency department”, “emergency medicine”, “emergency room” and “emergency care ” . And in the next stage the keywords such as “lean management” and “emergency” was collected from SID, Medlib, IranDoc, Google Scholar, MagIran, IranMedex data bases. For extracting the data data-extracting forms was prepared. The information we got from the forms was organized in information-extracting forms and was analyzed manually. The diagrams were drawn in Excel: 2010.Results:Finally, 26 essays have been included. Most of the studies were accomplished in Canada and U.S.A. only in one of the cases, the authors used the control group. Each of these terms, “lean techniques” and “lean principals”, with five times repetitions had the highest frequency. The most important team of implementation of lean management included: hospital management team or the manager of Emergency department, physicians, nurses, staffs and external counselors. Generally, 51 indicators were studied which among them the length of stay and the timing had the most frequency. After implementation of lean management, almost all studied indicators have significantly improved. 14 barriers, 14 facilitators and 10 effective factors were recognized in implementing the lean management.Conclusion:According to the studies, responsibility of organization’s senior management and his/her supports; increasing the knowledge of the characteristics and dimension of lean among the providers of health service; and decreasing the resistance and consulting with external counselors can have great effect on the success of lean management.

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Section: Discussionmentioning

confidence: 99%

Features and Results of Conducted Studies Using a Lean Management Approach in Emergency Department in Hospital: A Systematic Review

Isfahani

Tourani

Seyedin

2019

BEAT

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“…Työyhteisön näkyville sijoitetuilla lean-taulujen avulla fasilitoidaan ja seurataan toimintaa (24,26,29,32,34). Taulut sisältävät tyypillisimmillään laatuun, kustannuksiin, turvallisuuteen, tuotantoon ja etiikkaan kohdistuvaa tietoa, jota käsitellään päivittäisissä pikaneuvotteluissa (32).…”

Section: Johdantounclassified

Lean-ajattelu ja lean-päivittäisjohtaminen yliopistosairaaloissa

Maijala

Eloranta

Ikonen

2020

SLA

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Terveydenhuollossakin sovellettava lean-ajattelu korostaa jatkuvaa parantamista ja lisäarvon tuottamista asiakkaille. Lean-päivittäisjohtamisen piirteitä ovat mittaamisen ja lean-taulujen avulla tapahtuva visuaalinen seuranta, vastuu toiminnasta ja päivittäiset lyhyet moniammatilliset tiimikokoukset. Tämän tutkimuksen tarkoituksena oli tunnistaa lean-päivittäisjohtamisen piirteitä ja siihen liittyvää osaamista sekä lean-ajattelun hyödynnettävyyttä yliopistosairaaloissa. Aineisto kerättiin neljästä suomalaisesta yliopistosairaalasta lean-ajattelua soveltavilta asiantuntijoilta kyselyillä (N = 41) ja teemahaastatteluilla (N = 15) marraskuun 2017 ja kesäkuun 2018 välillä. Aineistot analysoitiin aineisto- ja teoriaohjaavalla sisällönanalyysilla. Lean-ajattelun periaatteet sopivat yliopistosairaaloihin. Lean-ajattelun soveltaminen edellyttää valmentavaa johtamista ja koko henkilöstön sitoutumista, organisaation eri tasoilla. Soveltamista rajoittaa osa terveydenhuollon kulttuurin piirteistä: hierarkkisuus, menettelytapojen kankeus ja epäselvät prosessit. Lean-ajattelun periaatteita ja työkaluja käytettäneen tulevaisuudessakin, mutta ajattelumallin odotetaan muokkaantuvan ja hyödyn paranevan, kun lean-ajattelu yhdistetään muihin johtamis- ja kehittämismalleihin. Lean-päivittäisjohtamisen ei arvioitu olevan vakioitunutta yliopistosairaaloissa, mutta sen piirteitä tunnistettiin ja samalla tarve niiden vahvistamiseen. Piirteitä ovat kommunikaatio ja viestintä, mittaaminen ja seuranta, osaamisen hallinta, valmentava johtaminen, tiimityön ja muutoksen tukeminen, jatkuva parantaminen, hukan poistaminen sekä strategian mukainen toiminta ja tavoitteiden asettaminen. Lean-ajattelun systemaattinen soveltaminen terveydenhuollon organisaatioissa edellyttää selkeitä strategiassa kuvattuja visiota ja tavoitteita, jalkautussuunnitelmaa sekä johdon ja henkilöstön sitoutumista siihen. Lean-päivittäisjohtamisen vahvistamiseksi tarvitaan jatkuvan parantamisen menettelyjen ja seurantamittareiden systemaattista kehittämistä.

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“…It will include lean management as one of the approaches used to improve efficiency and quality in service provider organizations 61 65 ; and, 8) Supervision , defined as routine control visits by senior primary care staff to providers and facilities 66 72 .…”

Section: Intervention and Outcomes Of Interestmentioning

confidence: 99%

Evidence gap map of performance measurement and management in primary care delivery systems in low- and middle-income countries – Study protocol

et al. 2018

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Background . For the last two decades there has been growing interest in governmental and global health stakeholders about the role that performance measurement and management systems can play for the production of high-quality and safely delivered primary care services. Despite recognition and interest, the gaps in evidence in this field of research and practice in low- and middle-income countries remain poorly characterized. This study will develop an evidence gap map in the area of performance management in primary care delivery systems in low- and middle-income countries. Methods. The evidence gap map will follow the methodology developed by 3Ie, the International Initiative for Impact Evaluation, to systematically map evidence and research gaps. The process starts with the development of the scope by creating an evidence-informed framework that helps identify the interventions and outcomes of relevance as well as help define inclusion and exclusion criteria. A search strategy is then developed to guide the systematic search of the literature, covering the following databases: Medline (Ovid), Embase (Ovid), CAB Global Health (Ovid), CINAHL (Ebsco), Cochrane Library, Scopus (Elsevier), and Econlit (Ovid). Sources of grey literature are also searched. Studies that meet the inclusion criteria are systematically coded, extracting data on intervention, outcome, measures, context, geography, equity, and study design. Systematic reviews are also critically appraised using an existing standard checklist. Impact evaluations are not appraised but will be coded according to study design. The process of map-building ends with the creation of an evidence gap map graphic that displays the available evidence according to the intervention and outcome framework of interest. Discussion . Applications arising from the evidence map will be discussed in a separate paper that will summarize findings and make recommendations for the development of a prioritized research agenda.

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Implementing a Lean Management System in Primary Care

Abstract: Although Lean offers a new approach to delivering care, the implementation process itself is both complex and crucial to success. Understanding early facilitators and barriers can maximize Lean's, potential to improve health care delivery.

Cited by 38 publications

References 23 publications

Features and Results of Conducted Studies Using a Lean Management Approach in Emergency Department in Hospital: A Systematic Review

Features and Results of Conducted Studies Using a Lean Management Approach in Emergency Department in Hospital: A Systematic Review

Lean-ajattelu ja lean-päivittäisjohtaminen yliopistosairaaloissa

Evidence gap map of performance measurement and management in primary care delivery systems in low- and middle-income countries – Study protocol

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